The Mentally Disabled Women: Sterilization at the Request of Others
On December 13, 2006, the United Nations General Assembly,as reported in the
International Herald Tribune approved the “first convention protecting rights of world’s 600 million disabled people.” According to the article,the convention “guarantees that the disabled have the inherent right to life on an equal basis with the able-bodied and requires countries to prohibit discrimination on the basis of disability and guarantee equal legal protection. Countries must also ensure the equal right of the disabled to own and inherit property, to control their financial affairs, and to privacy over their personal lives.” The convention will enter into force when it is ratified by 20 countries. One of the issues that concern disability activists is the “forced sterilization of girls and women because of their disability, forced institutionalization and substitute decision making.”
It is my understanding that governmental ordered (forced) permanent sterilization of mentally disabled women in the United States has been abolished in the past several decades. Sterilization, to prevent pregnancy, of a woman who is mentally unable to provide informed consent varies in the different states but can be performed only on the direct request of a legal guardian with physician recommendation and/or court approval. The obvious medical rationale for performing such a procedure would be to prevent harm if further pregnancy or delivery would endanger the life or health of the mother. However, if this is not the case, the social rationale would be to prevent harm to the child if the mother is mentally unable to provide appropriate care or as a consequence of the pregnancy an unnecessary burden placed on society or the guardian with regard to the financial or other responsibilities to care for the child. Another social argument would be to prevent any genetic basis for the mental handicap to be passed on to future generations—eugenics. The latter argument for mandatory sterilization, as originally approved by the Supreme Court in 1927, was overturned in 1942 by the Court.
Here is the ethical issue to my visitors: Do you find any excuse for the permanent sterilization of a mentally disabled woman ethical on the basis of a decision by others without the woman’s own personal and informed consent? How about non-surgical, non-permanent contraceptive medication use without consent? ..Maurice.
posted by Maurice Bernstein, M.D. @ 8:56:00 AM
47 comments
47 Comments:
mentally challendged people should have the right have children even if the society has to pay for it,
Do the mentally challenged have a right to have children if they do not even understand what that means? There was an earlier discussion on this blog about parents who stopped a child's growth so as to best be able to care for her at age 6 -- a severely mentally disabled child.
If a woman is too mentally disabled to understand and consent to the physical condition of pregnancy; if she is not able to understand herself how to avoid pregnancy, and if she is likely to be unable to prepares physically or mentally for childbirth (thus finding it traumatic), I think there is an argument for sterilization at the behest of the caregiver and in consultation with medical professionals. It is ethical because it is in the best interests of the patient not to put her through childbirth or pregnancy, which would be incomprehensible and frightening.
In this instance, and in this instance only, I would consider sterilisation. I would not advocate the long term use of medical birth control because it would seem the side effect profile over a long term would cancel out the benefits of "being in the best interests of the patient".
Dr. Bernstein, the first thing I would want to do is ensure that the woman in question is truly is unable to deal with her own life issues, or make her own choices ... I've seen labels and definitions applied rather creatively in the past ...
Secondly, if the question is one which would affect the woman permanently, I would want to be certain that the woman's "disability" is permanent, and not one that she could conceivably recover from in the future.
Once those criteria are established, I don't believe that the potential mother should be put through the trauma of a childbirth ... and it would also be unfair to the child, on several levels.
Contraception at the request of others in the above circumstances is one thing. Sterilization is a bit more serious, and would be traumatic on its own, and I think should be avoided if possible. Once a child is conceived, however, I believe that it should be given a chance at life.
I have worked with severe/profoundly cognnitively impaired children/young adults for 7 years. Many of the females are put on some form of birth control by their parents or legal guardians. When this happens, it is for the same medical reasons that a non-disabled female would be placed on birth control (highly irregular menses, extemely heavy periods, extreme moodiness/PMS around menses). I do not think this is unethical.
Nobody is thinking about the life of the poor child that is born and has to suffer through the trauma of growing up and dealing with the stress of an unwilling society that does not accept them, it is not their fault.
I FEEL THAT THE CHILD WILL STILL BE BROUGHT UP WITH AS MUCH LOVE AS A ABLE BODIED PERSON.THIER DISIBILITY SHOULDNT HINDER THEM FROM EXPERIENCING THE JOYS OF A CHILD BIRTH.IM POSITIVELY SURE THEYLL HAVE HELP AND SOCIETY WILL SEE IT AS A START AND THEY SHOULD BE ABLE TO LIVE A HAPPY NORMAL LIFE WITH THEIR CHILD.
I truly believe that no child should live with someone like my very close relative who is mentally challenged. She wanted to have a cat so she got one. The cat is still afraid of her, hiding whenever she is around. Just imagine for a second that Mambo is a child...We should hold the hand of people in need but we should also make it sure that people who are disabled mentally and has no sense of responsibility are not reproducing. It can be very dangerous and a risk is not a chance to take. Sterilisation should be a must when it appropriate.
I understand the compassionate cry of those who would not want to deny a disabled woman the wonders of having and raising a child. However, as a parent of a mentally disabled young woman, I am panicked to think of my daughter raising a child. She can just barely care for her most basic physical needs, never mind about her emotional ones. The baby/child would not be safe with her alone, and it's already a full time job for us to look out for her. Having a baby would push us (and the ever dwindling mental health system) over the edge. Honestly, it makes me angry to hear arguments assuming that "she'll be taken care of." By whom?!
Those who have come to this thread may be interested in reading a more recent thread where a case is discussed regarding the parents of a "profoundly cognitively impaired 20-year-old daughter" whom they cared for at home "asked that their daughter’s ovaries be stimulated so her eggs could be harvested for fertilization with donor sperm and the resulting embryos brought to term by a contract birth-giver. They would then rear their grandchild themselves." Neither of the parents were capable of producing more children. They wanted their daughter to have a child for reasons of wanting to keep the family line intact.
If you want to write your opinion about that case, to maintain continuity, go to the above link and write your comments there. ..Maurice.
Ok.... the thing is, i believe there needs to be a criteria that needs to be fulfilled in order for people with mentally impaired diseases to have offspring. These criteria need to make sure the said person can fully fathom the idea of pregnancy, childbirth, proper care of a child, and the ability to UNDERSTAND the ramifications of introducing life into this world. The person(s) also need(s) to realize that by bringing this child into the world, they are condemning it into to a life of hardship and a world that does not fully accept it.
Just a thought from a 16 year old boy.
I actually just stumbled across this debate in trying to find help for my friends. They have a 13 year-old daughter with severe autism and down syndrome. She will never be able to speak, she still isn't potty trained, and she will never be able to lead a "normal" life.
I did behavioral therapy with her for two years, and she's also had some excellent behaviorists, speech pathologists, and OTs working with her. The thing is that despite all this help, she still doesn't and never will have a very good grasp on proper social comportment, let alone the more complex issues of conception and child raising. I'm looking for some way that my friends can get sterilization so she doesn't have to endure the indignity of dealing with bloody diapers every month.
I'm definitely pro-life, but any person who spends even ten minutes with this girl can tell that she will never be having children. This is a case where her "reproductive rights" will cause her more social stigma (if, as is likely, she has incidences of exposing bloody diapers to people or doing other socially inappropriate things) and a lower quality of life (how do you explain menstruation to someone who doesn't understand potty training?) than if her parents were allowed to get her sterilized.
I understand and agree that this issue should be approached with compassion and others' best interests at heart, but in this case that would mean sterilization for this little girl. As a concerned friend of this family, I would love for them to not have to fight an uphill legal battle to ensure that their daughter has a better life. Does anyone know of any solutions?
JB
I have a teenaged daughter that is borderline MR and severely mentally ill, she is violent, angry, aggressive, with no warning she can lash out and destroy anything in her path, she has killed animals, her biological mother was mentally ill, and she has undoubtly passed those genes on to my adoptive daughter, she is going through the teenage hormone changes and doesn't truely understand what the changes to her body means with her history of killing small animals, and violence, I would fear for the life of a small child if she were to get pregnant, and have children in the future, If I could find a doctor that would agree to sterilize her it would already be done. For those of you posting that you don't think it is right and so forth, you have not lived my life, you have no idea what it is like to care for a child like this, my daughter will never be able to care for herself much less a child, so any decision as to her health should not be made by people that do not live with the consequences, it should be made by the caregivers and the medical professionals.
Thank you to all of you with your opnions in this ethical dilemma. I am a college student writing a paper for a Medical Ethics class on the very same 6 year old girl(pillow angel) spoken about in the begining of these writings. Your opnions and experiences have given me alot to expand on and think about.
it is nobodies right to take away someone else's right to have children.
If we allow such a thing then what right to the disabled have over their body?
What makes them different than the general population, that they can not have children?
I presume all the visitors would reject the idea that in place of sterilization the very act of sexual intercourse should be prevented since one would argue that is a suggestion impossible to carry out. ..Maurice.
My 21 y/o is developmentally disabled, functioning at a 4th grade level. She has some basic living skills, but needs help even with personal hygiene. She had her first child last year who is being raised by our parents. She is pregnant again, the babies will be only a year apart. My husband and I are looking to adopt this baby.
My sister refuses to take birth control. She wants babies, the same way a child wants to play house. She doesn't see herself as having a disability and thinks she's a great mother despite abandoning her son for several weeks at a time without even a phone call.
I wish we could seek court ordered sterilization. If she continues at her current rate, she could have a child every year for the next 20 years. We will run out of relatives to care for these children. They will become wards of the state. For people who say it's cruel to take away her reproductive rights, I want to know how cruel they think it is to take a baby out of the arms of a mother who can't understand why she can't keep her baby. Wouldn't preventing future pregnancies be less emotionally brutal than losing her child?
This is a very interesting discussion, I'm glad I found it. Just wanted to give my two cents.
I have done research on sterilisation of mentally disabled girl child, in my masters programme where we were given a case of a mentally disabled girl whose parents wanted court permission to get her sterilised.
The very simple reason why parents want their children to undergo this, is not because they don’t like their daughter or that they don’t want to become grand parents but because they were afraid of any misfortune that may befell their angel whom they are protecting. Their main fear being what if she was raped or some pervert had sex with her although she couldnt understand what was happening to her and as a result she becomes pregnant. How will she handle the hormonal mood swings et all.
The Commission refers the Court to Article 7 of the Declaration on the Rights of Mentally Retarded Persons, which is scheduled to the Human Rights and Equal Opportunity Commission Act 1986 (Cth), which states:
"Whenever mentally retarded persons are unable, because of the severity of their handicap, to exercise all their rights in a meaningful way or it should become necessary to restrict or deny some or all of these rights, the procedure used for that restriction or denial of rights must contain proper legal safeguards against every form of abuse. This procedure must be based on an evaluation of the social capability of the mentally retarded person by qualified experts and must be subject to periodic review and to the right of appeal to higher authorities."
The High court of Australia has also laid down the criterion for allowing sterilization, i.e.
• The child should be profoundly intellectually disabled.
• It should be for the benefit of the child.
• It should be opted as a last resort after going through alternative and less drastic resorts
• It should be necessary to avoid grave or unusual problems and sufferings.
• There must be competent medical advice and also the court should be satisfied beyond the shadows of all reasonable doubt, that this is the last resort after looking through various less severe options and that it is for the welfare and in the best interest of the child.
I completely agree with the guideline laid down by the court, if the special little angel is never going to become one amongst the so called normal people why add to her sufferings with all the mood swings and the threat to her life and that of her child. Not to forget making the parents go through apart from everything else they are facing in protecting their angel
HRK
Severely mentally retarded who cannot care for themselves cannot certainly care for a child. Also they are at risk of being raped and sexually abused. Their legal guardians should be able to arrange sterialization for the long term well being of the retarded person.
To sterilize a human being for being mentally or physically disabled is by no means humane. they still have a say in what happens to their body, even if they cannot voice their opinions because of their mental state they still have a right to give consent to proceed with the sterilization or forced birth control. Even if a person is severely mentally disabled it is in the parent or guardians best interest to make sure that the individual is cared for in a safe environment. sterilization of the severely mentally disabled is not necessary if this is acted upon (therefore the chances of rape or sexual molestation is down to a minimum).
-KD
I agree that even the mentally disabled should have the right to give consent to sterilization or forced birth control, depending on the level of the profoundness of their disability.This story from my hometown is of a family,parents who though maybe not profoundly retarded, were nevertheless below average intelligence, their 2 sons and 2 daughters all of whom were profoundly mentally retarded.The boys slept with their sisters when they became sexually active,the sisters became pregnant,all were sterilized, and the girls institutionalized, because these subnormal parents were incapable of preventing this incest as well as impregnation of their daughters by their sons.I agree with the mother who says you don't know what you are talking about unless you are the family or a medical professional. A medical professional___mas
For more details about the history and practice of compulsory sterilization, you can read the article in Wikipedia
..Maurice
Sterilization may prevent pregnancy due to the abuse of individuals with cognitive impairment, but shouldn't we be focusing on preventing the abuse and rape of these girls and women?
Yes, yes.. is anybody on this thread thinking about the responsibilities of those men who are the primary causes of this dilemma in management?
Should they be held responsible for whatever are the consequences of their decision to engage in sex with the mentally disabled woman? ..Maurice.
Sterilization is a poor excuse for prevention. In some of the cases mentioned here, a Depo shot (or similar) would be a far less invasive solution. The problem, of course, is not the person who functions at a level that most can agree is severely impaired. No, the problem arises when we use this red pen of who deserves fertility, an inalienable right, and who doesn't. Do we start characterizing depression or anxiety as disorders that should make a woman incompetent to reproduce? Or do we consider substance abusers unworthy of parenthood? If so, which substances--legal and/or illegal--qualify? Nicotine? Cocaine? Rx drugs? No family nor physician has the right to play God.
To the poster who said that a girl having menses in diapers suffers indignity, the real indignity here is that you would work to deny her womanhood and the beauty of a fertility cycle. If the young lady is showing her diapers to people, I'm sure there are other substances in her Depends to cause all the humiliation one can spare; blood would actually evoke sympathy from people since only a woman with severe issues would neglect her menstrual hygiene. Then again, are you really trying to paint an image of someone who flings poo and blood? If so, menstruation is the least of her troubles. It's not looking good on the parts of the 'caregivers' either at that point.
Finally, this discussion is inherently biased. Let's discuss forced sterilization of challenged MALES. "Wait, gentlemen! Don't run so quickly! Do return with your wholesale opinions on how medical 'professionals' (term used loosely, given the behavior of many in this group, bound by a symbolic serpent) should manage women's rights to their bodies." Smh
And what about the male in this issue ? Would any man engaging in sex with a mentally disabled woman be considered as a sexual offender regardless the response to this action by the woman? ..Maurice.
I think this man can be considered an offender even if he means well and the woman seems to agree. though in most cases it is probably a disabled person as well, or someone who is truly offending the woman
This thread has been super interesting to read. I understand both sides of opinions, but I have to say, I think ultimately, caregivers should be the ones to decide only if the person, whether male or female, should be sterilized ONLY if he or she is truly mentally incapable of basic care of themselves and only if it were truly in the best interest of the patient to have it done. I know that some of you believe that it is their body and that they should have right to decide, and while yes it is their body, they may or may not be able to even grasp the concept of even having the choice, therefore not able to truly make a decision due to their lack of understanding. But I have to say, I wouldn't have wanted to live in the 1920s when people would get put in an asylum for things that are considered normal or curable today. Example, girls who had problems with their cycle would even be admitted. Just stupid, and Kansas wanted to sterilize those "not good enough" (weren't good looking, health problems, etc) so only those with good traits would produce offspring and have the undesirables fade out.
I am a grandmother raising mentally disabled grandchildren. I adopted their mother at the age of four weeks, only to discover at the time she was around two years of age that she was mentally disabled. At age fifteen she became pregnant and by the age of twenty-three she had had seven children. I took custody of four, while the other three were adopted. My grandchildren suffer from mental disabilities through inheritance and their mother's abuse of alcohol during pregnancy. Permanent Sterilization of the mentally disabled sounds harsh to people who have not raised mentally disabled children. Those of us who have perhaps see it as more of a way to avoiding the possible suffering by the subsequent children. I have since decided to give my now teenage granddaughter the birth control pill, albeit against her will, as she is incapable of realizing the outcome of not taking it. Due to my experience I definitely believe in substitute decision making.
Hello, I'm a 56 single mom of a wonderfule 24 year old down syndrome daughter. Although she is high functioning in some areas, in many she is not. From our day to day life, I can tell you, I hate having her on meds to prevent pregnancy. They have side effects, and postpone the inevitable decision that she will not have children. I'd like to think she can explore her sexuality, but leave pregnancy out of it. It's also very very difficult and traumatizing when she does have a period. So why put her thru this time after time?
I'm seeking a quality of life her.
thanks for allowing me to share.
As a health care professional who provides in-home care for petople, including persons with mental disabilities, I would like to put my two cents worth in on this subject. Very rarely is a person who is mentally disabled able to care for a child. This does not mean that the mentally disabled person is a bad person. It is just a fact. They simply do not have the wisdom and problem solving capabilities that child rearing requires. I care for people with all kinds of mental disabilities, not just mentally challenged (aka mentally retarded). I don't have anything at all against people with mental disabilities. They are all unique, just like anyone without a mental disability. But I do not think that it is in the best interest of any child to be raised by a parent who is mentally challenged. Sometimes you just have to consider what is best for the child, not the parent. A mentally challenged person should not get to have a child just in case they are able to raise it. (Anonymous in MO)
Love this thread. I have to write an essay today over whether sterilization of mentally retarded people is right or wrong. It's been very hard for me to chose a side, but I chose this topic over other controversial reproduction topics. This thread helps me see all kinds of different opinions. Anyways.
I first thought that only people with severe mental disabilities should be sterilized to prevent them from having children who they could not take care of. And talking to others, my opinions have changed. All people, even those who are mentally ill, have feelings and can love. Love cannot be quantified, and everyone expresses their love and feelings in different ways. Science cannot say mentally retarded people are incapable of unconditionally loving for their children or are completely incabable of taking care of them. So what about the couples who are both mentally challenged have dreams of having children but are denied the opportunity or choice? It would be devastating and heartbreaking. What exactly labels them mentally retarded and what determines the severity of their retardation? Is it an IQ below a certain number (80, correct?), a level of care they cannot give to themselves, let alone a child, or other (countless) factors and conditions? In this instance, should ALL people who cannot care for themselves (including the mentally retarded, homeless, addicted, prisoners, poor, etc.) be sterilized? Well, I think not. Everyone should have a choice. (I know everyone is not a very great noun to use.) Do [you] (not you specifically, of course) want some nameless agency deciding what happens to the mentally disabled, creating rules that all must follow, not taking into consideration each persons individual situation and feelings?
Poke.
~ 16 year old Sarah.
I do not agree with the sterilization of those with disabilities at all. I have a disability, there was a time I was declared incompetent and my mother was my substitute decision maker, if legally allowed she would have had me forcibly sterilized heck she would have had me euthanized. 10 years later I am now living on my own, no longer "incompetent" and planning for my first child. Birth control is one thing to permanently alter someone, absolutely not.
Lily
Lily, I don't personally know you but I am positively impressed by what you wrote. You have written "...and planning for my first child". How many women who would have been declared "COMPETENT" could honestly state that they had "planned" for a pregnancy and a child. Best wishes. ..Maurice.
Though this is a sensitive issue and i think the decision in such matter should include say 60% value to doctors/medical reports, 25 % family and 15 % value to the will of the patient.15% value to the patient can only be fair enough if the patients 'will' is judged properly. by will i mean how strongly the women feels about kids or having a child (this judgement could also include her past, may be she had shown strong desire to have child before being challenge or exreseed in some way, this could be done by proper research on her pas/ or present frients/ visitors/family)
and sterlisation should only be done if the total comes out atleat 80%.
@ Maurice, i strongly felt that your question asking HOW many competent women.........planned child...is not fair enough.
Even if it is 1 single women (LILy atlest we know now) She COUNTS and this no. (even if as small as 1) can not be neglected...
regards
K
But K, I truly wonder if the decision regarding sterilization can be determined by mathematics. ..Maurice.
I am amazed at how people continue to repeat that sterilizing a profoundly mentally delayed person is a violation of their rights. There is no such thing as "the right to reproduction" when the person cannot understand or function beyond being able to breathe, make noise, or move their bodies. How can someone like this have children? What good can come of it?
Most people against sterilization of the mentally challenged don't even have enough experience caring for one to have an opinion on this topic. I don't think there should be government enforced sterilizations but the lawful caretaker of a mentally challenged person should have the right to have the sterilization done.
If a human being is incapable of living by themself, doing the shopping, cooking, and so on, then they are incapable of caring for a child. They are still children themselves but in a mature human body.
Continueing from previous post... We aren't talking about a regular teenage kid that gets knocked up and has to learn how to be responsible at 14 years old. We are talking about human beings that have brains that can only comprehend at the level of a four year old and will never ever improve. They are taken care of by family or the state and will always be. Therefore, it should be the decision of the person caring for them, the person that will end up having to raise the baby or find a home for it, to decide whether sterilization is best.
As for the people saying birth control shots are just as good, what happens when an appointment is missed or antibiotics are used and there is an accidental pregnancy? It happens all the time.
And the people saying we just need to make sure no pervy guys get to them, ridiculous. Of course the caretakers do everything they can to put them in safe environments.
In my case, I have a mentally challenged sister. We discovered that she was delayed at a young age and then she was diagnosed with schizophrenia at age 9. She is on a ton of medication but it doesn't make all of her dellusions go away. Her biological mother was also schizophrenic l. If my sister were to have a baby it would most likely have early onset schizophrenia and be mentally challenged like her. My parents can't handle taking care of another special needs person and I know I can't handle what they have gone through. So should we just hope that our sexually promiscious mentally challenged relative doesn't get pregnant. And if she does, should we rip the infant away from her and put it in the foster care system? I'm assuming that the baby will also be severely deformed due to her anti-psychotic drugs that she has to take so that she doesn't get paranoid and violent. Btw, my sister has told me time and time again that she wants babies and we explain that she can't because they will have the same disease as her. She could just refuse to take her birth control and have lots and lots of violent paranoid schizophrenic mentally challenged
Fi, left out the last word of the previous posting: kids. ..Maurice.
This has been really interesting for me to read. Tomorrow I have to do an assesmemt for GCSE on a rant of why people should be sterilised and this has been really helpful to see both sides. Thank you
~14 year old student
:)
Sorry, I worked in the social service field and have had CPS involved in my own family through 3 generations....I really feel that the last thing we need are more babies born to people that can't provide for them. That means emotionally, physically and financially.
To today's commentator: the "patho-physiology" of the phenomena you describe is simply that impregnation is just too simple and uncomplicated and in the United States and elsewhere there is still governmental attempts to prevent abortions at any fetal age and regardless of the emotional, physical and financial circumstances. ..Maurice.
This is an interesting read. I have a 20 year old daughter with an intellectual disability. She is not severely disabled and quite capable of tending to her own hygiene and basic food needs. She also keeps a schedule and is quite personable in public. She has no concept of money or the passage of time. That being said, her boyfriend sprayed her in the face with his water bottle and she had a total melt down on him. If she is changing a baby boys diaper and gets "sprayed" and goes off on the baby who amongst those advocating her reproductive rights are going to be there to support her against child abuse charges? Or better yet, be there watching to prevent it in the first place? Allowing her to exercise her reproductive rights does not automatically make her capable of being a mother and it does not guarantee the care and safety of any child she has. The first thing my daughter said when she got her menses was that now she could have a baby. She would love to have a baby but has no concept of the years of unceasing commitment it would take to raise that baby nor does she have the ability to hold a job to support that baby. She would not be willing to give up the baby should she become pregnant and she would not be capable of consistent long term care of an infant or child. When it gets to that stage what takes precedence, her right to keep and attempt to raise a child or the right of the baby to a safe and nurturing environment? Who amongst those of you advocating for her reproductive rights is willing to stop living your life and live hers along side of her when she has a child in order to ensure the health and safety of that child? You should also be willing to provide her emotional and financial support as that is what will need to be done. Is it kinder to rip a child out of her arms or to keep her from having that child in the first place?
In response to bernlee, it is kinder to prevent the woman from having a child than removing a living child from its mother. One has to look at the act from the whole picture: sterilization simply affects one person, the woman. Removing a child from a woman who can't be a mother to her child, now affects two persons. And one, the infant, can be considered the "innocent" part of the decision. Well, one could argue that the infant is not really an "innocent" party since, since it is the infant's inability to function without maternal attention that has led to the concept of sterilization. ..Maurice.
I agree with Maurice. As the 74 year old mother of a profoundly disturbed daughter, I have been through the heartache and grief that the entire family suffers when a child has to be taken by the state because of the mothers inability to care for herself. She had two sons before her illness was fully developed and my husband and I took custody and later adopted those two. In the meantime she gave birth to a daughter who was removed directly from the neonatal section of the hospital by the state because she would have been in danger if my daughter had custody. Which my daughter didn't really want, anyway. Years of mental health deterioration later, she gave birth to another baby. She asked the doctor who delivered the baby if he would do a tubal ligation then and there. He told her rather coldly that she couldn't afford the $6,000 procedure and he informed her that Medicaid wouldn't pay for it. The hospital called the police and had her taken to a mental health hospital so she could be put back on her psych meds. That baby was still floating around in the system six months later, having been born with some birth defects. We don't know if she was ever put into a permanent home, having been born of two parents with severe mental illness. They had met in an assisted living facility where sex was encouraged as a perceived "right" and a privilege which could be withheld when the resident was not compliant.
Meanwhile our two boys have the knowledge that they have two sisters that they will never get to know. In addition, they have had a rough road to travel, having had their mentally ill mother in and out of their lives, and having to deal with the stigma and the unpredictability of her behavior, which sometimes becomes totally inappropriate. We shielded them from most of it when they were younger, but now it is harder because as her illness worsens, we find ourselves more involved in her life. They are 17 and 19 now and both have struggled with a tendency to use drugs and alcohol. We are their only safe harbor and I'm still glad we didn't listen to the first social worker who told us that in order to do right by the boys we would have to cut our daughter out of our lives if we took custody. They have had to learn more than most people will ever know about mental illness and compassion. But to let her try to raise them would have been devastating to her and to them.
The family, the caretakers and the medical experts should all be allowed to agree on sterilization in the face of profound mental illness with a significant duration or even at the emergence of any hint of violence. If the mentally ill person isn't allowed the joy or torture of child birth, it is of secondary importance to the grief the person or the child and all the rest of the involved family will suffer indefinitely.
Shouldn't drive a car at all, that is for sure.
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